Nicolae BACALBASA, Olivia IONESCU and Irina BALESCU

ABSTRACT

Rationale. Since its introduction in the early 1990s, sentinel lymph node biopsy (SLNB) is regarded as the standard treatment for patients with clinically negative axillary lymph nodes (LNs) on initial presentation. Classically, when the SLN biopsy is negative, the axillary LN dissection (ALND) is no further necessary. On the other hand, performing complete ALND in case of a positive SLNB is controversial, recent data from randomized controlled studies suggesting that, in these cases, the tumor biology has a greater impact on the adjuvant treatment decision than the completion of an ALND.

Objective. The aim of this review is to ascertain whether axillary LN surgery has survival benefits in women with early breast cancer and SLN involvement, either micro-metastatic or macro-metastatic. Moreover, it tries to assess the value of SLN biopsy before and after primary systemic chemotherapy and its role in the staging of the axilla in locally recurrent breast cancer.

Materials and method. We searched Pubmed, Medline, the Cochrane Register of Controlled Trials and G.I.N (Guidelines International Network) databases for English language articles about the need of ALND in women with both positive and negative SLNs using controlled vocabulary (e.g. “breast cancer”) and key words (e.g “sentinel lymph node”, “axilla dissection”). The analysis was restricted to retrospective studies and randomized controlled trials focusing on survival benefits in terms overall (OS) or disease-free survival (DFS).

Conclusions. There is increasing evidence which indicates that ALND can be avoided in a specific group of patients with early breast cancer, even though the SLNB is positive. A correlation between the clinico-pathological features of the breast cancer and the probability of residual disease in the axilla, could allow the selection of cases in which ALND can be omitted. In the context of neo-adjuvant chemotherapy, it is not yet established if positive SLNs could be converted to negative SLNs after chemotherapy as the rate of false-negative results is still high.

Keywords: sentinel lymph node, breast cancer, biopsy, axillary dissection

Full text | PDF

Alexandra Gireada, Nicolae BACALBASA and Irina BALESCU

ABSTRACT

ASO reaction is one of the most commonly used laboratory tests especially due to the fact that Group A Streptococcal infection is a very often seen situation. Epidemiological studies have shown that ASO titers widely vary among different age groups and population groups; wide variations related to the moment of determination have been also reported.

Keywords: ASO reaction, Group A streptococcal infection, ASO antibodies

Full text | PDF

Nicolae BACALBASA, Alexandra Gireada and Irina BALESCU

ABSTRACT

Ovarian cancer is one of the most lethal malignancies due to an aggressive biological behavior of a tumor usually diagnosed in an advanced stage of the disease. Due to the fact that important differences in terms of survival have been observed between cases diagnosed in early stages when compared to those in FIGO stages III-IV, attention was focused on establishing which is the most appropriate laboratory diagnostic test which could help the clinician to diagnose and treat the disease in a less advanced stage. This is a literature review of the most frequently used tumor markers and scores used in ovarian cancer diagnostic and follow up.

Keywords: ovarian cancer, CA 125, HE 4, ROMA score, OVA1

Full text | PDF